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Funding: (…) The Portuguese Mental Health Study was carried out by the Department of Mental Health, Faculty of Medical Sciences, NOVA University of Lisbon, with collaboration of the Portuguese Catholic University, and was funded by Champalimaud Foundation, Gulbenkian Foundation, Foundation for Science and Technology (FCT) and Ministry of Health. (…). AimsIntermittent explosive disorder (IED) is characterised by impulsive anger attacks that vary greatly across individuals in severity and consequence. Understanding IED subtypes has been limited by lack of large, general population datasets including assessment of IED. Using the 17-country World Mental Health surveys dataset, this study examined whether behavioural subtypes of IED are associated with differing patterns of comorbidity, suicidality and functional impairment.MethodsIED was assessed using the Composite International Diagnostic Interview in the World Mental Health surveys (n = 45 266). Five behavioural subtypes were created based on type of anger attack. Logistic regression assessed association of these subtypes with lifetime comorbidity, lifetime suicidality and 12-month functional impairment.ResultsThe lifetime prevalence of IED in all countries was 0.8% (s.e.: 0.0). The two subtypes involving anger attacks that harmed people ('hurt people only' and 'destroy property and hurt people'), collectively comprising 73% of those with IED, were characterised by high rates of externalising comorbid disorders. The remaining three subtypes involving anger attacks that destroyed property only, destroyed property and threatened people, and threatened people only, were characterised by higher rates of internalising than externalising comorbid disorders. Suicidal behaviour did not vary across the five behavioural subtypes but was higher among those with (v. those without) comorbid disorders, and among those who perpetrated more violent assaults.ConclusionsThe most common IED behavioural subtypes in these general population samples are associated with high rates of externalising disorders. This contrasts with the findings from clinical studies of IED, which observe a preponderance of internalising disorder comorbidity. This disparity in findings across population and clinical studies, together with the marked heterogeneity that characterises the diagnostic entity of IED, suggests that it is a disorder that requires much greater research. publishersversion published

BACKGROUND: Antidepressants remain controversial, partly due to allegations that disappointing results were buried and because of their modest average efficacy. AIM: To investigate bias in the antidepressant literature and the possibilities for predicting which patients with depression or anxiety do receive significant benefits from antidepressants. METHOD: We investigated bias by comparing information from the US Food and Drug Administration with the published literature. To predict response, we used patient data from randomized trials. RESULTS: Of all studies on depression or anxiety, 50% and 72% were positive, compared to 95% and 96% of all published studies. Safety outcomes were poorly reported in published articles and unpublished studies were often 'bundled' into pooled-trials publications with positive conclusions. We found an association between severity and antidepressant efficacy for some, but not all, anxiety disorders; previous research has found inconsistent evidence for this association for depression. Furthermore, patients with depression that showed early improvement were more likely to attain a good response, irrespective of which symptoms improved. CONCLUSION: These results demonstrate the severe impact of bias on the antidepressant literature. Severity and early improvement predicted a good response, but more information is needed to improve predictions. The increased accessibility of individual patient data will hopefully soon enable further progress in this area.

PURPOSE: To determine whether the use of quantitative personal exposure measurements in experimental research would result in better estimates of the associations between static and time-varying magnetic field exposure and neurocognitive test performance than when exposure categories were based solely on distance to the magnetic field source. METHODS: In our original analysis, based on distance to the magnet of a 7 T MRI scanner, an effect of exposure to static magnetic fields was observed. We performed a sensitivity analysis of test performance on a reaction task and line bisection task with different exposure measures that were derived from personal real-time measurements. RESULTS: The exposure measures were highly comparable, and almost all models resulted in significant associations between exposure to time-varying magnetic fields within a static magnetic field and performance on a reaction and line bisection task. CONCLUSION: In a controlled experimental setup, distance to the bore is a good proxy for personal exposure when placing subjects at fixed positions with standardized head movements in the magnetic stray fields of a 7 T MRI. Use of a magnetic field dosimeter is, however, important for estimating quantitative exposure response associations.

Background: Weight gain and undesirable changes in body composition in women receiving chemotherapy (CT) for early stage breast cancer is a common, but poorly understood phenomenon. This sarcopenic obesity consists of an increase in fat mass and a decrease in lean body mass, which is associated with disease recurrence, an increased risk of cardiovascular disease and diabetes, lower quality of life, and a lower overall survival. The purpose of this study was to explore in-depth the perceptions of women with breast cancer on determinants of changes in body composition and muscle strength as dietary intake, physical activity and quality of life and their possible interventions on these potential changes. Interpreted against the individual measurements made during the treatment trajectory such as changes in weight, fat mass, lean body mass. Methods: As part of a greater mixed methods study, a longitudinal qualitative multiple case study was conducted. Newly diagnosed women with breast cancer were recruited and purposively selected (n = 18) from several hospitals in the Netherlands before the start of their treatment with CT. Semi structured face-to face interviews were conducted during the treatment trajectory at three time points: before start of CT, (T1), halfway (T2) and after CT (T3). Interviews (n = 54) were audiotaped and transcribed verbatim. A thematic content analysis approach was used to explore women's perceptions, such as changes in weight and taste and to interpret these qualitative findings against the individual quantitative data such as changes in weight, fat mass, lean body mass (DEXA scans), BMI, muscle strength and results of the Hospital Anxiety and Depression Scale (HADS). Results: All women, mean age 51 yr (26-65 yr) experienced known side effects from CT such as hair loss, nausea, sore mouth, mucositis. Fourteen out of 18 women gained weight between 2 and 7 kg; three women lost some weight (3-7 kg), whereas one woman lost 14 kg. All women said to be less physically active and complained about fatigue. They all experienced undesirable changes regarding taste, smell and food preferences sometimes leading to loss of appetite. Others experienced more appetite despite changes in food preferences or changes in taste and smell. Depending on their illness perception women differed in how they acted upon these changes. Some women monitored the impact of therapy reactively, other women tried to respond proactively and often creatively to all changes that happens to them. Results of the interviews were supplementary and explanatory to the weight and BMI changes and the results of the HADS. Conclusion: Suffering from weight changes, being less physically active, monitoring changes differently are important elements to take into account for the development of interventions to prevent weight gain in women with breast cancer during CT.